ARCHITECTURE
The Neighbourhood Health Centres Initiative is an efficient, cost-effective way to provide our NHS with the future-proofed buildings it needs. A standardised approach, whether for large or small projects, aims to systematise design to ensure value for money and support delivery. Historically, NHS hospitals have been built individually by trusts and funded by public finances, with projects often over budget and delayed. We need a credible approach with a focus on standardising plans with future flexibility, as well as a more accurate delivery timeline.
A standardised design considers the whole project, from
Above: Royal Liverpool University Hospital (RLUH) is also part of the New Hospital Programme.
Above right: RLUH interior, with natural materials such as wood creating a domestic feel.
Translating healthcare design expertise into the Neighbourhood Health Centres initiative represents a shift from fragmented service delivery to a model where care is shaped around people, place, and community. The ambition is to improve routine care for everyone, strengthen proactive support for people with complex needs, and create credible alternatives to hospital-based care.
Navigating the crisis The NHS is crumbling, physically, with some of its facilities. It was starved of capital in the 2010s, with £37bn in underinvestment, meaning the country did not build enough new hospitals to keep up with demand today. The Neighbourhood Health Framework is positioned as a complement to the New Hospital Programme (NHP), established in 2020. Both programmes are tasked with identifying ways to improve the efficiency and quality of health facility construction, whether large-scale acute hospitals or smaller projects, through a centralised approach. Both Royal Liverpool University Hospital (RLUH) and Midland Metropolitan University Hospital (MMUH) are part of the New Hospital Programme, which our practice has been directly involved with.
Neighbourhood health is central to the government’s aim of shifting care from hospitals to communities and from treatment to prevention. Rural and underserved areas require new care models that improve connectivity and access, supported by scalable infrastructure, repeatable layouts, and transferable design logic. NHS strategy is moving between centralised acute hospitals and community focused hubs to widen access, infrastructure essential nationwide, particularly in rural and underserved regions.
64 Health Estate Journal August 2026
the outside and the inside, and can have a net-positive impact on its staff, patients, and the environment. It can support client trust and partnerships and deliver credibility. Having a model that can be replicated with slight tweaks, and a scalable framework with transferable approaches is invaluable, with specific design details ranging from adaptability and flexibility to materials and access to nature and natural light.
Designing for impact: standardisation as a tool for excellence All projects have budget constraints and keeping this at the forefront of mind in design is crucial. Learning how to balance aesthetics with budgets is a critical part of the design process. Community health centres need to be about bringing care closer to home, with comprehensive facilities where patient safety and the personal level of care are major factors, alongside design components such as construction, layout, and interior details. Design thinking is critical, and with it comes a
range of tools that directly support the neighbourhood health agenda, from human-centred insights to inform neighbourhood models and reflect what communities value to an understanding of the user experience of navigating services. Architects’ design experience includes considerations for user experience, operational modelling spans variable estates, and understands clinical services strategies.
Our work as designers also includes systems mapping
to help Integrated Care Boards and local authorities understand patient pathways; prototyping and developing new models of care and new physical environments before scaling; and place-based design, including understanding location, orientation, and building context, and their impact within the community. One specific design element from our work that
felt radical at the time but could actually be the ‘silver bullet’ for a modern rural health hub is thinking about the grid. Applying a single structural grid to align parking,
Matt Livey
Matt Livey
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